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Arthroplasty Increases MI and VTE risk

Although osteoarthritis patients who have an arthroplasty are at increased risk of myocardial infarction in the early post-operative period, a more long-term risk is that of venous thromboembolism, according to a study from Boston-based researchers published recently in Arthritis and Rheumatology.1

The present cohort study included 13,849 patients who underwent total knee replacement surgery and 13,849 matched controls who did not have surgery. Patients were 50 years of age or older and diagnosed with knee or hip osteoarthritis between January 2000 and December 2012.

Findings indicate that 306 patients in the arthroplasty group and 286 in the non-surgical group developed myocardial infarction during the follow-up period. Risk of heart attack was significantly higher during the first postoperative month in those who had knee replacement surgery compared to those in the non-surgical group, and gradually declined over time. Venous thromboembolism was a significant risk during the first month and over time for those having total knee or total hip arthroplasty.

“While evidence shows that joint replacement surgery improves pain, function, and quality of life for the osteoarthritis patient, the impact of cardiovascular health has not been confirmed,” explains lead study author Professor Yuqing Zhang (Boston University School of Medicine, Boston, Massachusetts, USA). “Our study examines if joint replacement surgery reduces risk of serious cardiovascular events among osteoarthritis patients,” she added.

Professor Yuqing Zhang (Boston University School of Medicine)

Professor Yuqing Zhang (Boston University School of Medicine)

“Our findings provide the first general population-based evidence that osteoarthritis patients who have total knee or total hip replacement surgery are at increased risk of heart attack in the immediate postoperative period,” concludes Dr Zhang. “The long-term risk of heart attack was insignificant, but risk of blood clots in the lung remained for years after surgery to replace a hip or knee damaged by osteoarthritis.”

References

1. Lu N, Misra D, Neogi T, Choi HK, Zhang Y. Total joint arthroplasty and the risk of myocardial infarction – a general population, propensity score-matched cohort study. Arthritis Rheum 2015 http://dx.doi.org/10.1002/art.39246

Published on: September 30, 2015

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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